Critical Access Hospital

also known as: CAH · Critical Access

A small rural hospital designation that receives cost-based Medicare reimbursement instead of IPPS — required to be ≤25 beds and >35 miles from another hospital.

Critical Access Hospitals (CAHs) are a Medicare facility designation created by the 1997 Balanced Budget Act to preserve rural healthcare access. To qualify: - ≤25 inpatient beds - >35 miles from the nearest hospital (or >15 miles in mountainous terrain) - Provide 24/7 emergency services - Average inpatient length of stay ≤96 hours In exchange for these constraints, Medicare reimburses CAHs at 101% of allowable costs rather than under IPPS. This protects small rural hospitals from the per-discharge math that would otherwise make them unprofitable. There are roughly 1,300 CAHs in the U.S. — about 20% of all U.S. hospitals — concentrated in rural areas of states like Texas, Kansas, Nebraska, Iowa, and Minnesota.
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